Room F, 10/16/2000 2: 00 PM - 4: 00 PM (PS) Dexamethasone in Anorectal Surgery: Does It Increase the Risk of Wound Complications?

Abstract. Background: Insufficient evidence exists to support the safety of carotid endarterectomy (CEA) following intravenous thrombolysis (IVT) for acute ischaemic stroke. Our study aimed to report a single-centre experience of patients treated over a five-year period. Patients and methods: Departmental computerised databases were interrogated to identify patients who suffered an ischaemic stroke and subsequently underwent thrombolysis followed by CEA. Mortality and stroke within 30 days of surgery were defined as the primary outcome end points. Results: Over a five-year period, 177 out of a total of 679 carotid endarterectomies (26 %) were performed in patients presenting with acute ischaemic stroke. Twenty-five patients (14 %) received IVT prior to CEA in the form of alteplase. Sixty percent of patients were male with a mean age of 68 years. Sixteen patients (64 %) underwent CEA within 14 days of IVT and the median interval between thrombolysis and CEA was 7.5 days (range, 3–50 days). One female patient died of a further intraoperative stroke within 30 days of surgery, yielding a mortality rate of 4 %. Two patients (8 %) suffered from cardiac complications postoperatively resulting in a short high dependency unit stay. Another two patients (8 %) developed local wound complications, which were managed conservatively without the need for re-operation. The median hospital length of stay was 4.5 days (range, 1–33 days). Conclusions: Our experience indicates that CEA post-thrombolysis has a low incidence of mortality. Further high quality evidence is required before CEA can be routinely recommended following IVT for acute ischaemic stroke.

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Obese Cardiac Patients: Significant Reduction of Deep Sternal Wound Complications by Wearing the Posthorax™ Vest?

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0036-1571705 ◽

2016 ◽

Vol 64 (S 01) ◽

Author(s):

K. Buschmann ◽

J. Bienias ◽

L. Brendel ◽

I. Halbroth ◽

A. Ghazy ◽

...

Keyword(s):

Cardiac Patients ◽

Wound Complications

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Psychological influences on wound healing

Perspectives in Surgery ◽

10.33699/pis.2019.98.8.312-314 ◽

2019 ◽

Vol 98 (8) ◽

pp. 312-314

Keyword(s):

Wound Healing ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Wound Complications ◽

State Of Mind ◽

Life Threatening ◽

Psychological Influences ◽

Fear And Anxiety ◽

Care Costs

Surgical wound complications remain a major cause of morbidity; although usually not life threatening, they reduce the quality of life. They are also associated with excessive health care costs. Wound healing is affected by many factors – wound characteristics, infection, comorbidities and nutritional status of the patient. In addition, though, psychological stress and depression may decrease the inflammatory response required for bacterial clearance and so delay wound healing, as well. Although the patient´s state of mind can be influenced only to a certain extent, we should nevertheless stick to ERAS (Enhanced Recovery After Surgery) guidelines and try to diminish fear and anxiety by providing enough information preoperatively, pay due attention to postoperative analgesia and seek to provide an agreeable environment.

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Pilonidal sinus disease: Karydakis flap procedure in our patients

Perspectives in Surgery ◽

10.33699/pis.2020.99.8.350-355 ◽

2020 ◽

Vol 99 (8) ◽

Keyword(s):

Wound Healing ◽

Pilonidal Sinus ◽

Healing Process ◽

Pilonidal Sinus Disease ◽

Wound Complications ◽

Limberg Flap ◽

New Disease ◽

Sinus Disease ◽

Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

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Sternal Wound Complications in Bilateral Internal Thoracic Artery Grafting: A Comparison of the Off-Pump Technique and Conventional Cardiopulmonary Bypass

The Heart Surgery Forum ◽

10.1532/hsf98.20051150 ◽

2005 ◽

Vol 8 (6) ◽

pp. E456-E461

Author(s):

Naz Bige Aydin ◽

Tufan Sener ◽

Ilknur Kiygil Kehlibar ◽

Tansel Turkoglu ◽

Osman Eren Karpuzoglu ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Internal Thoracic Artery ◽

Wound Complications ◽

Off Pump ◽

Bilateral Internal Thoracic Artery

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A Multimodal Enhanced Recovery Program in Anorectal Surgery

Case Medical Research ◽

10.31525/ct1-nct03992079 ◽

2019 ◽

Author(s):

Keyword(s):

Enhanced Recovery ◽

Anorectal Surgery ◽

Enhanced Recovery Program ◽

Recovery Program

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Stapled Surgery for Hemorrhoidal Prolapse: From the Beginning to the Modern Times

Reviews on Recent Clinical Trials ◽

10.2174/1574887115666200310164519 ◽

2020 ◽

Vol 15 ◽

Cited By ~ 2

Author(s):

Alessandro Sturiale ◽

Bernardina Fabiani ◽

Claudia Menconi ◽

Danilo Cafaro ◽

Felipe Celedon Porzio ◽

...

Keyword(s):

Postoperative Bleeding ◽

Invasive Procedure ◽

High Volume ◽

Normal Mucosa ◽

Stapled Hemorrhoidopexy ◽

Wound Complications ◽

Rectal Intussusception ◽

Stapler Technique ◽

History Of ◽

Hemorrhoidal Prolapse

Introduction: Hemorrhoidal disease is the most common proctologic condition in adults. Among the different surgical procedures, one of the greatest innovations is represented by the stapled hemorrhoidopexy. The history of this technique started with a single stapler use passing thorough a double stapler technique to resect the adequate amount of prolapse, finally arriving to the use of high volume devices. Methods: Nevertheless each device has its own specific feature, the stapler is basically made up with one or more circular lines of titanium staples whose height may be variable. The procedure is based on different steps: Introduction of the CAD, evaluation of the prolapse, fashioning purse string or parachute suture, introduction of the stapler head beyond the suture, pull the wires through the window, close the stapler and keep pulled the wires of the suture held together with a forcep, fire using two hands, open the stapler and remove it and check the staple line and then check the specimen. One of the latest innovations in stapled surgery the Tissue Selective Therapy. It is a minimally invasive procedure in which there is a partial circular stapled hemorrhoidopexy focused on the prolapsing piles with bridges of normal mucosa left. Results: Several studies have reported that SH is a safe and effective procedure to treat the hemorrhoidal prolapse. It is a quicker procedure with a shorter hospital stay and earlier return to work if compared with the conventional treatment. This is due to a less postoperative pain, postoperative bleeding, wound complications and constipation. Furthermore, the first generation devices had worse outcomes if compared with those of the new generation stapler that showed lower postoperative complication rate with better anatomical and symptomatic results. Conclusions: Stapled procedure for the treatment of symptomatic hemorrhoidal prolapse represents one of the most important innovations in proctology of the last century bringing with it the new revolutionary concept of the rectal intussusception as a determining factor involved in the natural history of the disease. Stapled hemorrhoidopexy marked an era in which the surgeon may to offer to the patients a safe, effective treatment with less pain and fast recovery.

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Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery

Anesthesiology ◽

10.1097/aln.0b013e3182054d06 ◽

2011 ◽

Vol 114 (2) ◽

pp. 283-292 ◽

Cited By ~ 312

Author(s):

Laurent G. Glance ◽

Andrew W. Dick ◽

Dana B. Mukamel ◽

Fergal J. Fleming ◽

Raymond A. Zollo ◽

...

Keyword(s):

Blood Transfusion ◽

Noncardiac Surgery ◽

Pulmonary Complications ◽

Wound Complications ◽

Severe Anemia ◽

Thromboembolic Complications ◽

Mortality And Morbidity ◽

Risk Of Death ◽

Increased Risk ◽

The Impact

Background The impact of intraoperative erythrocyte transfusion on outcomes of anemic patients undergoing noncardiac surgery has not been well characterized. The objective of this study was to examine the association between blood transfusion and mortality and morbidity in patients with severe anemia (hematocrit less than 30%) who are exposed to one or two units of erythrocytes intraoperatively. Methods This was a retrospective analysis of the association of blood transfusion and 30-day mortality and 30-day morbidity in 10,100 patients undergoing general, vascular, or orthopedic surgery. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications. Results Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95% CI, 1.03-1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications, compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48-2.09), sepsis (OR, 1.43; 95% CI, 1.21-1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32-2.38), and wound complications (OR, 1.87; 95% CI, 1.47-2.37). Conclusions Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood.

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1113 The impact of BMI on postpartum infectious morbidities and wound complications: a study of extremes

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.1137 ◽

2021 ◽

Vol 224 (2) ◽

pp. S686

Author(s):

Iqra Sheikh ◽

Kateena Addae-Konadu ◽

Sarah Dotters-Katz ◽

Megan Varvoutis

Keyword(s):

Wound Complications ◽

The Impact

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